Dynamics of Illness Perception and Self-Regulation in Patients with Morbid Obesity Three Months after Bariatric Surgery

Background. Obesity has reached epidemic proportions throughout the world. Bariatric surgery (hereinafter - BS) is most effective in the treatment of morbid obesity (hereinafter - MO), however, it does not lead to the same results in all patients, since psychological factors play an important role in the outcome of treatment. The gap in scientific knowledge is the underestimation of the patient’s role in the treatment process, the lack of information about how he perceives medical treatment and manages the disease, how ideas about the disease change over time after surgery. Aim of the work: study of the dynamics of ideas about the disease and related parameters of self-regulation of the disease in patients with MO before surgery and three months after BS. Materials and methods. Sixty-three patients with MO were examined using a specially selected package of methods before BS and three months after it. The following methods were used in the study: brief illness perception questionnaire; Hospital anxiety and depression scale; Ways of coping questionnaire; Medication adherence report scale; Scales of psychological well-being. Results. Compared with the preoperative stage, three months after BS, patients perceived MO as a less life-threatening disease that has fewer negative consequences for their health and emotional well-being. Their controllability of the disease and the likelihood of curability of obesity after BS have increased. Conclusions. Three months after the operation, positive dynamics in the perception of MO and related parameters of self-regulation were revealed. The knowledge gained can be widely used in medical practice as targets for psychological interventions.

1. Andryushchenko A.V., Drobizhev M.Yu., Dobrovol'skii A.V. Sravnitel'naya otsenka shkal CES-D, BDI i HADS(d) v diagnostike depressii v obshchemeditsinskoi praktike [A comparative validation of the scale CES-D, BDI, and HADS(d) in diagnosis of depressive disorders in general practice]. Zhurnal nevrologii i psikhiatrii = S.S. Korsakov Journal of Neurology and Psychiatry, 2003, №5, pp. 11-18. (In Russ., аbstr. in Engl.)
2. Gureeva I.L., Volkova A.R., Semikova G.V. et al. Osobennosti pishchevogo povedeniya i udovletvorennost' kachestvom zhizni u patsientov s morbidnym ozhireniem posle bariatricheskoi operatsii [Features of eating behavior and satisfaction with the quality of life in patients with morbid obesity after bariatric surgery]. Vestnik psikhoterapii = Bulletin of psychotherapy, 2021, №1(77), pp. 116-128. (In Russ., аbstr. in Engl.)
3. Dedov I.I., Mel'nichenko G.A., Shestakova M.V. et al. Morbid obesity treatment in adults. [Lechenie morbidnogo ozhireniya u vzroslykh]. Ozhirenie i metabolism = Obesity and metabolism, 2018, vol.15, №. 1, pp. 53-70. DOI: 10.14341/OMET2018153-70 (In Russ., аbstr. in Engl.)
4. Vasserman L.I. et al. Metodika dlya psikhologicheskoi diagnostiki sposobov sovladaniya so stressovymi i problemnymi dlya lichnosti situatsiyami: posobie dlya vrachei i meditsinskikh psikhologov [Methodology for psychological diagnostics of ways to cope with stressful and personally problematic situations: a manual for doctors and medical psychologists]. Saint-Petersburg: The St. Petersburg Bekhterev Psychoneurological Research Institute, 2009. 38 p. (In Russ.)
5. Neimark A.E., Eganyan Sh.A., Grineva E.N. Psikhologicheskoe soprovozhdenie patsientov do i posle vypolneniya bariatricheskikh operatsii [Psychological assessment of the patients before and after bariatric surgery]. Consilium Medicum, 2016, №18(4), pp. 53—56. (In Russ., аbstr. in Engl.)
6. Chetverkina E.D., Gureeva I.L., Isaeva E.R. et al. Priverzhennost' k soblyudeniyu vrachebnykh rekomendatsii u patsientov c morbidnym ozhireniem do i posle bariatricheskikh operatsii [Compliance to medical recommendations in patients with morbid obesity before and after bariatric surgery] // Uchenye zapiski Pervogo Sankt-Peterburgskogo gosudarstvennogo meditsinskogo universiteta imeni akademika I. P. Pavlova = The Scientific Notes of the Pavlov University, 2022, №29(4), pp. 16-24. DOI: 10.24884/1607-4181-2022-29-4-16-24 (In Russ., аbstr. in Engl.)
7. Shevelenkova T.D., Fesenko T.P. Psikhologicheskoe blagopoluchie lichnosti [Psychological well-being of a person] // Psikhologicheskaya diagnostika = Psychological diagnostics, 2005, №3, рр. 95-121.
8. Yaltonskii V.M., Yaltonskaya A.V., Sirota N.A. i dr. Psikhometricheskie kharakteristiki russkoyazychnoi versii kratkogo oprosnika vospriyatiya bolezni [Psychometric properties of the Russian version of Brief illness Perception Questionnaire]. Psikhologicheskie issledovaniya = Psychological Studies, 2017, №10 (51), pp. 1. DOI:10.54359/ps.v10i51.407 (In Russ., аbstr. in Engl.)
9. Bartholomay E.M., Cox S., Tabone L. et al. The role of anxiety and depression in understanding the relationship between coping and weight loss 24 months after bariatric surgery. Surgery for Obesity and Related Diseases: official journal of the American Society for Bariatric Surgery, 2023, № 20(3), pp. 304-314. DOI:10.1016/j.soard.2023.10.004
10. Breland J.Y., Fox A.M., Horowitz C.R. et al. Applying a common-sense approach to fighting obesity. Journal of obesity, 2012, №8, 710427. DOI:10.1155/2012/710427
11. Cassin S.E., Sockalingam S., Du C. et al. A pilot randomized controlled trial of telephone-based cognitive behavioural therapy for preoperative bariatric surgery patients. Behavior Research and Therapy, 2016, №80, pp. 17—22. DOI:10.1016/j.brat.2016.03.001
12. Chan J.K.Y., Vartanian L.R. Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review. Obesity science & practice, 2024, №10(1), pp. 741. DOI:10.1002/osp4.741
13. Gill H., Kang S., Yena Lee J. et al. The long-term effect of bariatric surgery on depression and anxiety. Journal of Affective Disorders, 2019, №246, рр. 886—894. DOI:10.1016/j.jad.2018.12.113
14. Hood M.M., Corsica J., Bradley L. Managing severe obesity: understanding and improving treatment adherence in bariatric surgery. Journal of Behavioral Medicine, 2016, №39, pp. 1092-1103 (2016).  DOI:10.1007/s10865-016-9772-4
15. Jolfaei G.A., Zahedi Y., Pazouki A. et al. Relationship Between Coping Strategies and Outcome of Bariatric Surgery in Patients With Morbid Obesity (Persian). Current Psychosomatic Research, 2023, №1(3), pp. 346-359. DOI:10.32598/cpr.1.3.134.1
16. Kalarchian M.A., Marcus M.D., Levin M.D. et al. Psychiatric disorders among bariatric surgery candidates: association with obesity and functional health status. The American journal of psychiatry, 2007, №164(2), рр. 328—334. DOI: 10.1176/ajp.2007.164.2.328
17. Kral J.G., Kava R.A., Patrick M. et al. Severe Obesity: The Neglected Epidemic. Obesity Facts, 2012, №5(2), pp. 254-69. DOI:10.1159/000338566
18. Leventhal H., Phillips L.A., Burns E. The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management. Journal of Behavioral Medicine, 2016, №39(6), pp. 935-946. DOI:10.1007/s10865-016-9782-2
19. McAndrew L.M., Martin J.L., Friedlander M.L. et al. The common sense of counseling psychology: introducing the Common-Sense Model of self-regulation. Counselling Psychology Quarterly, 2017, №31 (4), pp. 497—512. DOI:10.1080/09515070.2017.1336076
20. Mittmann G., Schuhbauer M., Schrank B. et al. Effect of bariatric surgery on anxiety symptoms in morbidly obese patients: A systematic narrative literature review. Journal of Bariatric Surgery, 2023, №2, pp. 53-59. DOI:10.4103/jbs.jbs_5_23
21. Mora P.A., McAndrew L.M. Common-Sense Model of Self-regulation. In Gellman M.D., Turner J.R. (Eds). Encyclopedia of Behavioral Medicine. New York: Springer, 2013. pp. 460—467. DOI:10.1007/978-1-4419-1005-9_1220
22. Morisky D.E., Ang A., Krousel-Wood M. et al. Predictive validity of a medication adherence measure in an outpatient setting. The Journal of Clinical Hypertension, 2008, №10(5), pp. 348-354. DOI:10.1111/j.1751-7176.2008.07572.x
23. Müller A., Hase C., Pommnitz M. et al. Depression and suicide after bariatric surgery. Current psychiatry reports, 2019, №21(9), pp. 84. DOI:10.1007/s11920-019-1069-1
24. Pokorski M., Głuch A. Perception of Well-Being and Quality of Life in Obese Patients After Bariatric Surgery. In Pokorski M. (Ed.). Invasive Diagnostics and Therapy, New York: Springer, 2022. pp. 81-90. DOI:10.1007/5584_2021_678
25. Pyykkö J.E., Aydin O., Gerdes V.E.A. et al. Psychological functioning and well-being before and after bariatric surgery; what is the benefit of self-compassion? British Journal of Health Psychology, 2022, №27, рр. 96—115. DOI:10.1111/bjhp.12532
26. Ribeiro I., de Lourdes M., Gomes C. et al. Role of Well-Being in Bariatric Surgery Treatment for Severe Obesity. In Ahmad S.I. (Eds.). Obesity. New York: Springer, 2024. pp. 277-288. DOI:10.1007/978-3-031-62491-9_21
27. Rongrong Fu.Yu., Zhang Kepin Yu. Bariatric surgery alleviates depression in obese patients: A systematic review and meta-analysis. Obesity Research & Clinical Practice, 2022, №16(1), pp. 10-16. DOI:10.1016/j.orcp.2021.11.002
28. Sigit F.S., de Mutsert R., Lamb H.J. et al. Illness perceptions and health-related quality of life in individuals with overweight and obesity. International Journal of Obesity, 2022, №46, pp. 417—426. DOI:10.1038/s41366-021-01014-x
29. van Hout, G.C.M., Verschure S.K.M., van Heck G.L. Psychosocial Predictors of Success following Bariatric Surgery. Obesity Surgery, 2005, №15(4) , pp. 552-560. DOI:10.1381/0960892053723484
30. World Health Organization. Obesity. URL: https://www.who.int/news-room/facts-in-pictures/ detail/6-facts-on-obesity (Accessed: 10.08.2024)
31. Zhao L., Park S., Ward Z.J. et al. State-specific prevalence of severe obesity among US adults using self-reported body mass index bias correction. Preventing Chronic Disease, 2023, №20, 230005. DOI:10.5888/pcd20.230005